Ken Grauer, MD

APRIL 23, 2023

A cknowledgment : My appreciation to Chaim Katalan ( Laniado Hospital, Israel ) for the case and this tracing. = = R elated E CG B log P osts to Today’s Case : ECG Blog #205 — Reviews my S ystematic A pproach to 12-lead ECG Interpretation. It did — and the patient recovered uneventfully. =

EKG/ECG 195

EKG/ECG Wellness Operations Hospitals 195

RebelEM

JANUARY 29, 2024

Click here for Direct Download of the Podcast Paper: Aykan AC et al. Because the lungs receive 100% of cardiac output, it has been hypothesized that a lower dose of thrombolytic therapy may still be effective with a better safety profile [3][4]. REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

Stroke 133

Stroke Outcomes Hospitals Administration 133

RebelEM

MAY 29, 2024

REBEL Core Cast 123.0 – Posterior Epistaxis Click here for Direct Download of the Podcast. If you treat a posterior bleed at a hospital without ENT, I would transfer as surgical intervention is pretty common REBEL EM: Do Patients with Epistaxis Managed by Nasal Packing Require Prophylactic Antibiotics?

PPE 96

PPE EMS Hospitals Wellness 96

Don't Forget the Bubbles

FEBRUARY 5, 2025

All hospitals will have different makeups of trauma teams and possibly different levels of activation) Do I need any additional expertise outside of who would typically be in the trauma team? Some specific considerations could be: Team Who will be the trauma team leader? Do I need a trauma team activation? link] SafeLives.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

EM SIM Cases

JULY 28, 2024

Dr Brad Stebner is a staff emergency physician at Kelowna General Hospital. Atrial Fibrillation Download ECG 1: [link] ECG 2: [link] This case comes from Dr Aneesha Thouli and Dr Brad Stebner. His interests include medical education and leadership, sports medicine, and health care administration.

Leadership 52

Leadership Administration EKG/ECG Hospitals 52

RebelEM

NOVEMBER 1, 2023

In this podcast episode, three Emergency Medicine Physicians, Marco Propersi, Dan Wolf and Will Smith, discuss flow in relation to working in the ED, how it intersects with medical training, on shift performance and even in daily life outside the hospital. How can you set yourself up to achieve flow?

EMS 68

EMS Hospitals 68

EMDocs

JUNE 9, 2023

Podcast: Play in new window | Download (Duration: 15:51 — 21.8MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Safe prehospital transport of the agitated child In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. mg/kg/dose (PO/IM/IV) Midazolam – 0.25-0.5 mg/kg IN; 0.1-0.15

EMS 95

EMS Documentation/Coding Pediatrics Psychiatric 95

RebelEM

JULY 17, 2023

Click here for Direct Download of the Podcast Paper: Knack SKS et al. PMID: Clinical Question: Does a single dose of ketamine or etomidate used for rapid sequence intubation (RSI) of critically adults in the ED impact the SOFA score within 3 days of hospitalization? REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

Outcomes 93

Outcomes Emergency Department Administration Resuscitation 93

SheMD

JUNE 15, 2023

Do this as soon as possible, the best apartments, especially those closest to the hospital, fill up quickly. Rochester is a very bike-friendly town and I lived close to the hospital. As an added bonus, I downloaded apps that reward users for exercising in the form of gift-cards and monetary awards.

Hospitals 98

Hospitals 98

EM SIM Cases

JUNE 11, 2024

Dr Lunsford is an ER physician and Simulation Director for the Guthrie Robert Packer Hospital emergency medicine residency program in Sayre, Pennsylvania, USA. Organophosphate poisoning Download Case courtesy of Frank Gaillard, Radiopaedia.org. This case comes from Dr Philip Lunsford.

Poisoning 52

Poisoning PPE Academics Resuscitation 52

ALiEM

JULY 24, 2023

Sara Krzyzaniak (EM program director at Stanford) hosts this episode with Dr. Michelle Lin (ALiEM/UCSF) featuring all-star guests Dr. Alexis Pelletier-Bui (EM associate program director at Cooper University Hospital) and Dr. Elizabeth Werley (EM program director at Penn State Hershey).

EMS 52

EMS Hospitals 52

EM SIM Cases

NOVEMBER 3, 2023

Ultimately, the patient will require admission to hospital for ongoing treatment. Heat Related Illness Download ECG Curtesy of Life in the Fast Lane, ECG Library for sinus tachycardia. Link can be found here.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG EMS Hospitals 52

EM SIM Cases

DECEMBER 13, 2022

Clinical Vignette EMS has brought a direct transfer to Neurosurgery from surrounding hospital for SAH. Case Summary A previously healthy 46-year old woman is transferred from a surrounding hospital with CT-confirmed diagnosis of SAH with hydrocephalus. Download Case Here Critical Care Case 1- Subarachnoid Hemorrhage Download

Airway Management 40

Airway Management Academics Emergency Department Hospitals 40

Don't Forget the Bubbles

JULY 26, 2023

This has been trialled (out of hospital) in known children with SVT. Upside-down position for the out of hospital management of children with SVT, Bronzetti et al, International Journal of Cardiology 2017 this showed that a modified position (upside down) improved cardioversion rates from 33% to 67%. www.cats.nhs.uk/wp-content/uploads/guideline-intubation.pdf

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

EM SIM Cases

JANUARY 10, 2023

His academic interests are in education, simulation, and translational simulation; including where simulation can improve hospital and emergency department preparedness. DOWNLOAD CASE HERE GSW Vascular Injury Download He completed a fellowship in simulation through the U of O Skills and Simulation Centre.

Academics 40

Academics Emergency Department Hospitals Resuscitation 40

The Skeptics' Guide to EM

FEBRUARY 20, 2021

The presentation is available to listen to on iTunes and GooglePlay and all the slides can be downloaded […] The post SGEM Xtra: Dogmalysis 2021 first appeared on The Skeptics Guide to Emergency Medicine. The title of the talk “Dogmalysis: Five Medical Myths in Emergency Medicine”. Date: February 19th, 2021 This is an SGEM Xtra episode.

Fractures 52

Fractures Outcomes Hospitals 52

EM SIM Cases

FEBRUARY 15, 2023

Most hospitals have a critical care outreach or rapid response team that can be activated in these cases. Case Summary 57-year-old female with known history of myasthenia gravis and thymoma is admitted to hospital 48 hours prior for CAP and started on Ceftriaxone and Azithromycin. Download Case Here: Download Case

Airway Management 40

Airway Management Academics Resuscitation Hospitals 40

RebelEM

AUGUST 7, 2023

REBEL Cast Ep122: Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients Click here for Direct Download of the Podcast Paper: Bandyopadhyay A et al. that would not be possible in an agitated/combative patient.

Head Injuries 96

Head Injuries Airway Management Outcomes Burns 96

RebelEM

MAY 18, 2023

REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension Click here for Direct Download of the Podcast Paper: The National Heart, Lung and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4

Sepsis 99

Sepsis Shock Resuscitation Outcomes 99

RebelEM

FEBRUARY 21, 2024

REBEL Core Cast 118.0 – IM vs PO NSAIDs Click here for Direct Download of the Podcast Bottom Line Up Top: There is no difference in analgesic efficacy between oral and intramuscular NSAIDs. Clinical Scenario: A 34-year-old woman presents to the ED with back pain. What Your Gut Says: Give the ketorolac IM.

Administration 63

Administration Emergency Department EMS Research 63

The Skeptics' Guide to EM

DECEMBER 25, 2021

Disclaimer: “While I am proud to be attending this institution, my opinions expressed here are mine alone and do not represent my residency program, hospitals I work at, or any other affiliated organizations.” JAMA 2021 This was an SGEM Journal Club and all the slides from the presentation can be downloaded using this LINK.

CPR 52

CPR Administration Outcomes Hospitals 52

EM SIM Cases

DECEMBER 15, 2023

Download Case Here Crit Care 3- Spinal cord injury Download These cases can help individuals and teams prepare to identify and manage these patients who become newly, and sometimes unexpectedly, unstable. While awaiting OR for spinal stabilization, she decompensates into mixed respiratory failure and hemodynamic instability.

Fractures 40

Fractures Resuscitation Academics Shock 40

Dr. Smith's ECG Blog

MARCH 3, 2023

Another handy section is for troponin levels and their delta cut-offs, which can be modified according to the kit used in your hospital. The App can be download from Apple App Store and Google Play Store in English, Turkish, French, German, Spanish, Chinese, Russian, Azerbaijani ( according to your phone's language ).

EKG/ECG 52

EKG/ECG Research Hospitals Wellness 52

Total Medical ComplianceHIPAA

NOVEMBER 13, 2023

As Electronic Health Record (EHR) companies prepare for potential fines reaching up to $1 million regarding information blocking violations, healthcare practices and hospitals find themselves at the cusp of impending changes. An informative download outlining exceptions to information blocking is accessible via the above link.

Documentation/Coding 52

Documentation/Coding Hospitals 52

EM SIM Cases

AUGUST 17, 2023

Chris Ding, Jane Kim, Jessica Stetz, and Sigrid Wolfram of SUNY Downstate/Kings County Hospital Centre. Dr. Ding completed emergency medicine residency at SUNY Downstate/Kings County Hospital in Brooklyn, NY. lvad-pump-thrombosis Download This case comes to us from Drs.

Emergency Department 40

Emergency Department EMS Hospitals Resuscitation 40

RebelEM

MARCH 13, 2024

REBEL Reflections Episode 5: Thinking in Bets – Making Better Decisions When You Don’t Have All the Facts Click here for Direct Download of the Podcast Think back to the last time someone asked you a difficult question regarding a patient on shift. How sure were you about your decision? Was there a clear-cut right or wrong answer?

Documentation/Coding 58

Documentation/Coding Outcomes EMS Stroke 58

RebelEM

JUNE 5, 2023

A systematic review of low-dose induction case reports (63 cases) in ambulatory and hospital settings successfully transitioned individuals on various opioids to buprenorphine without significant withdrawal (5). Initial doses ranged between 0.2 to 0.5mg over 4 to 8 days with the fully titrated dose ranging from 8 to 16mg (5).

Emergency Department 88

Emergency Department Hospitals Outcomes EMS 88

EMDocs

JUNE 2, 2023

Podcast: Play in new window | Download (Duration: 19:53 — 27.3MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Pharmacologic Management In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

Psychiatric 85

Psychiatric Pediatrics Emergency Department Administration 85

EM SIM Cases

JUNE 25, 2024

Crit Care 4- Post-extubation Stridor Download These cases can help individuals and teams prepare to identify and manage these patients who become newly, and sometimes unexpectedly, unstable. The team will need to manage the patient’s airway, eventually requiring re-intubation.

Academics 40

Academics Hospitals Wellness 40

ACEP Now

JANUARY 30, 2024

This focus on insurer consolidation broadens ACEP’s recent advocacy efforts with the Federal Trade Commission on hospital and physician consolidation, non-competes, and corporatization of medicine. Download the ACEP app for your devices or use the web-based version online on acep.org/poctools.

Pediatrics 52

Pediatrics EMS Documentation/Coding Stroke 52

The Skeptics' Guide to EM

APRIL 2, 2022

AEM March 2022 * Population: Patients ages 13-17 years who presented to the pediatric ED with mild to moderate acute pain (pain score 2-6 on FACES pain scale) * Exclusions: Patients with developmental delays, inability to speak English, prone to motion sickness, significant visual/hearing impairment, pregnancy, parental refusal, received analgesic (..)

Pediatrics 52

Pediatrics Emergency Department Outcomes Research 52

SheMD

JUNE 4, 2023

July 1st is almost here and hospitals around the country will welcome in their new interns. Download UpToDate and Epocrates at the very least from the app store – these are great apps to quickly read up on a diagnosis or to answer questions about dosing. It's that time of the year. Wishing you all the best next week. You CAN do this!

Academics 52

Academics Hospitals Research 52

Downeast Emergency Medicine

DECEMBER 1, 2021

329 participants were enrolled at an urban teaching hospital over a period of four years. Rosenberg and colleagues took a qualitative approach when investigating barriers and facilitators to successful implementation of ED-initiated buprenorphine programs in critical access hospital EDs across Maine. ROSENBERG ET AL.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

EMDocs

MAY 26, 2023

Podcast: Play in new window | Download (Duration: 17:49 — 24.5MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Non-Pharmacologic Management In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. Patients may be brought to hospital by police under restraint (e.g.

Pediatrics 94

Pediatrics Emergency Department Psychiatric Documentation/Coding 94

RebelEM

JUNE 26, 2024

Definition: A serum potassium level > 5.5 patients can jump from peaked T waves to sine wave) Management Basics: ABCs, IV, O 2 , Cardiac Monitor and, 12-lead EKG Identify + treat underlying cause of hyperkalemia (i.e. rhabdomyolysis -> hydration) Remove inciting factors (i.e. furosemide) Dialysis for anuric patients (i.e.

EKG/ECG 58

EKG/ECG Administration Burns EMS 58

Downeast Emergency Medicine

MAY 16, 2022

All three groups had similar rates or admission to the hospital and return to the ED. The primary outcome was the rate of ICU admission, with the secondary outcomes being the rate of mechanical ventilation, the overall rate of hospitalization, length of hospital/ICU stay, the total dose of drugs, and the number of protocol violations.

Outcomes 52

Outcomes Emergency Department Hospitals Wellness 52

RebelEM

NOVEMBER 2, 2022

The benefit of paracentesis on hospitalized adults with cirrhosis and ascites. Bacterial infection in patients with advanced cirrhosis: a multicentre prospective study. Dig Liver Dis 2001; 33(1): 41-48. PMID: 11303974 Gaetano et al. Journal of Gastroenterology and Hepatology 2016. PMID: 26642977 Wong CL et al.

EMS 52

EMS Administration Hospitals 52